10.64.01.01. 01 Definitions.. A. In this chapter the following terms have the meanings indicated.. B. Terms Defined.. 1) “Accompany the patient to the hospital” means, in the case of a transfer of care to a hospital, the direct-entry midwife:a) If possible, will ride in the ambulance with the patient; or. b) Travel by other means to the hospital.. 2) “ACME” means the Accreditation Commission for Midwifery Education or a successor organization that is:

10.64.01.02. 02 Scope of Practice.. The practice of direct-entry midwifery includes:. A. Providing the necessary supervision, care, and advice to a patient during a low-risk pregnancy, labor, delivery, and postpartum period;B. Newborn care authorized under Health Occupations Article, §8-6C-02, Annotated Code of Maryland, provided in a manner that is:1) Consistent with national direct-entry midwifery standards; and. 2) Based on the acquisition of clinical skills necessary for the care of pr

10.64.01.03. 03 Scope of Practice ― Prohibitions.. A. The practice of direct-entry midwifery does not include:. 1) Pharmacological induction or augmentation of labor or artificial rupture of membranes before the onset of labor;2) Surgical delivery or any surgery except an emergency episiotomy;. 3) Use of forceps or vacuum extractor;. 4) Except for the administration of a local anesthetic, administration of an anesthetic;. 5) Administration of any kind of narcotic analgesic; or.

10.64.01.04. 04 Required Consultation.. A. A licensed direct-entry midwife shall consult with a health care practitioner and document:. 1) The consultation;. 2) The recommendations of the consultation; and. 3) The discussion of the consultation with the client if any of the following conditions are present during prenatal care:a) Significant mental disease, including depression, bipolar disorder, schizophrenia, and other conditions that impair the ability of the patient to p

10.64.01.06. 06 Assistant for Home Birth.. At the time of delivery, a licensed direct-entry midwife shall be assisted by a second individual who has:A. Completed the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) within the previous 2 years; andB. The skills and equipment necessary to perform a full resuscitation of the newborn in accordance with the principles of NRP.

10.64.01.08. 08 License Required and Exceptions.. A. An individual shall be licensed by the Board before the individual may practice direct-entry midwifery in the State.B. This regulation does not apply to:. 1) An individual who assists at a birth in an emergency;. 2) An individual who is licensed as a health care practitioner whose scope of practice allows the individual to practice direct-entry midwifery; or3) A student who is practicing direct-entry midwifery while engaged in a Bo

10.64.01.09. 09 Patient’s Refusal to Transfer Care.. A. If a patient chooses to give birth at home in a situation prohibited by this chapter or in which a licensed direct-entry midwife recommends transfer, the licensed direct-entry midwife shall:1) Transfer care of the patient to a health care practitioner; and. 2) Complete the standard form developed under Regulation .10 of this chapter and:. a) Submit the completed form to the accepting health care practitioner; and.

10.64.01.10. 10 Plan of Care.. A. A licensed direct-entry midwife shall develop a general written plan for:. 1) Emergency transfer of a patient, a newborn, or both;. 2) Transport of a newborn to a newborn nursery or neonatal intensive care nursery; and. 3) Transport of a patient to an appropriate hospital with a labor and delivery unit.. B. The Committee shall review and recommend approval to the Board of the plan required under §A of this regulation.C. The plan required unde

10.64.01.11. 11 Informed Consent Agreements.. A. Before initiating care, a licensed direct-entry midwife shall obtain a signed copy of the Board-approved standardized informed consent agreement.B. The agreement developed under §A of this regulation shall include acknowledgment by the patient of receipt, at a minimum, of the following:1) The licensed direct-entry midwife’s training and experience;. 2) Instructions for obtaining a copy of the regulations under this chapter;.

10.64.01.12. 12 Required Reports.. A. Annually, beginning October 1, 2016, a licensed direct-entry midwife shall submit a report to the Committee, in a form specified by the Board, of the following information regarding cases in which the licensed direct-entry midwife assisted during the previous fiscal year ending June 30, when the intended place of birth was an out-of-hospital setting:1) The total number of patients served as primary caregiver at the onset of care;.

10.64.01.13. 13 Direct-Entry Midwifery Advisory Committee.. A. There is a Direct-Entry Midwifery Advisory Committee within the Board.. B. Committee Appointments.. 1) The Committee shall consist of seven members appointed by the Board, in accordance with the following.a) Three shall be licensed direct-entry midwives;. b) Two shall be licensed registered nurses certified as nurse-midwives;. c) One shall be a representative of the Maryland Hospital Association; and. d) One shall be a consume

10.64.01.14. 14 Committee Duties.. A. The Committee shall:. 1) Review applications for licensure as a licensed direct-entry midwife and make recommendations to the Board regarding applicants;2) Maintain a list of all licensed direct-entry midwives;. 3) Make recommendations to the Board regarding continuing education requirements for licensed direct-entry midwives;4) Review advertising by licensed direct-entry midwives and by institutions that offer a direct-entry midwife program and mak

10.64.01.15. 15 Qualifications of Applicants for Initial Licensure.. A. An applicant shall:. 1) Be of good moral character;. 2) Be a high school graduate or have completed equivalent education;. 3) Be 21 years old or older;. 4) Hold a current cardiopulmonary resuscitation (CPR) certification issued by the American Red Cross or the American Heart Association;5) Have completed in the past 2 years the American Academy of Pediatrics or American Heart Association Neonatal Resuscitation Program (NRP)

10.64.01.16. 16 Applications for Licenses and Issuance of Licenses.. A. To apply for a license to practice direct-entry midwifery an applicant shall submit:. 1) To a criminal history records check (CHRC) in accordance with Health Occupations Article, §8-303, Annotated Code of Maryland;2) A completed application to the Board on the form that the Board requires; and. 3) Written, verified evidence that the requirement submissions to a CHRC in accordance with Health Occupations Article, §8-30

10.64.01.17. 17 Term and Renewal of License and Reinstatement of License.. A. A license issued under this regulation authorizes the licensee to practice direct-entry midwifery while the license is active.B. A license:. 1) Expires on October 28 of every odd-numbered year;. 2) Is valid for 2 years, except for an initial license issued before the next renewal date;. 3) Issued for less than the full 2-year period shall be renewed at the next annual renewal date; and.

10.64.01.19. 19 Prohibited Acts.. A. Unless authorized to practice direct-entry midwifery, an individual may not represent to the public by title, description of service, method, procedure, or otherwise, that the individual is authorized to practice direct-entry midwifery in the State.B. A licensee may not advertise in a manner that is unreasonable, misleading, or fraudulent.. C. Unless authorized to practice direct-entry midwifery, an individual may not use the abbreviation